Provider Demographics
NPI:1528950425
Name:PARKISON, JENNIFER L (RN, BSN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:PARKISON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 HYDE PKWY
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:NY
Mailing Address - Zip Code:14522-1236
Mailing Address - Country:US
Mailing Address - Phone:585-704-7286
Mailing Address - Fax:585-704-7286
Practice Address - Street 1:800 W MILLER ST STE 6
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-1354
Practice Address - Country:US
Practice Address - Phone:315-332-2517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY737138-01163WE0003X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WE0003XNursing Service ProvidersRegistered NurseEmergency